Remote Claims Specialist - No-Fault & PIP Expert

AAA-The Auto Club Group; Fremont Township (MI); Remote; USD 67,000 - 105,000; Full time

Benefits offered by this job

AAA membership with roadside & travel

Adoption assistance

401(k) plan with company match

PTO & holidays

Job summary

AAA-The Auto Club Group is seeking a Claim Specialist in the United States to evaluate coverage, assess claim exposures, and resolve complex claim scenarios with minimal supervision.

Ideal candidates will apply Michigan No-Fault regulations, perform thorough investigations, and collaborate with insureds, medical providers, and attorneys while ensuring compliance with company standards.

Qualifications

• Three years of experience or equivalent training in negotiation and securing evidence

Responsibilities

• Review assigned claims and initiate claim handling activities.
• Contact insureds and other affected parties to gather information and set expectations for the claims process.
• Document claim activity and maintain accurate records within the claims management system.
• Perform complex coverage analysis and identify applicable policyholder benefits.
• Establish and manage sub-claims as needed.
• Conduct investigations to determine coverage, validity, policy limits, exclusions, and recovery opportunities.
• Analyze claim facts, damages, state laws, and other factors impacting decisions.
• Evaluate losses and authorize appropriate payments.
• Negotiate settlements and resolutions with strong negotiation skills.
• Refer claims to specialized departments when necessary (Underwriting, Recovery Units, SIU).
• Ensure complete documentation and compliance with procedures.
• Handle Michigan PIP claims including specific injuries and MCCA.

Skills

Negotiation

Evidence gathering

Estimates preparation

Subrogation

Coverage questions

Statements handling

Time management

Communication

Customer service

Problem solving

Education

Bachelor’s degree or equivalent

Associate degree or equivalent

Tools

Claims management system

Basic PC software

Job description

AAA-The Auto Club Group is seeking a Claim Specialist in the United States to evaluate coverage, assess claim exposures, and resolve complex claim scenarios with minimal supervision.

Ideal candidates will apply Michigan No-Fault regulations, perform thorough investigations, and collaborate with insureds, medical providers, and attorneys while ensuring compliance with company standards.